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NPI Code Detail

MEDICARE: MRS. KAREN ELISABETH PETERS R.D.

MEDICARE: MRS. KAREN ELISABETH PETERS R.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian2001022563MO

General Provider Information

NPI Number : 1730423781
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KAREN ELISABETH PETERS R.D.
Provider Business Mailing Address
First Line : 6121 N HANLEY RD
Second Line :
City : BERKELEY
State : MO
Zip : 63134-2003
Country : US
Telephone Number : 314-615-0877
Fax Number :
Provider Business Practice Location Address
First Line : 6121 N HANLEY RD
Second Line :
City : BERKELEY
State : MO
Zip : 63134-2003
Country : US
Telephone Number : 314-615-0877
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2012
Last Update Date : 11/15/2012

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